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Underground Storage Tank <br /> Spill Containment Testing Report Form <br /> 6. SPILL CONTAINMENT DETAILS <br /> Test Method Developed by ❑ Manufacturer 0 Industry Standard ❑ Professional Engineer <br /> Test Type ❑ Pressure Q Vacuum El Hydrostatic <br /> ❑ Check this box if Appendix 6.1 continuation page is attached. <br /> Tank ID Regular Premium <br /> Spill Containment Manufacturer: OPw OPw <br /> Method of Cathodic Protection ❑ Nonmetallic 0 Nonmetallic ❑ Nonmetallic ❑ Nonmetallic <br /> ❑ Other ❑ Other ❑ Other ❑ Other <br /> Is the spill containment ❑ yes 0 Yes ❑Yes ❑ Yes <br /> minimum capacity five gallons <br /> excludin riser volume? El No* El No* El No* El No* <br /> Method to keep spill ✓❑ Drain 0 Drain ❑ Drain ❑ Drain <br /> containment empty ❑ Pump ❑ Pump ❑ Pump ❑ Pump <br /> ❑ Other ❑ Other El Other ❑ Other <br /> Spill Containment Test Results ❑ Pass 0 Pass ❑ Pass ❑ Pass <br /> ❑ Fail ❑ Fail ❑ Fail ❑ Fail <br /> Tank ID <br /> Spill Containment Manufacturer: <br /> Method of Cathodic Protection ❑ Nonmetallic ❑ Nonmetallic ❑ Nonmetallic ❑ Nonmetallic <br /> ❑ Other ❑ Other ❑Other ❑ Other <br /> Is the spill containment ❑ Yes ❑ Yes L Yes ❑ Yes <br /> minimum capacity five gallons ❑ No* ❑ No* ❑ No* ❑ No* <br /> excluding riser volume? <br /> Method to keep spill ❑ Drain ❑ Drain ❑ Drain ❑ Drain <br /> containment empty ❑ Pump ❑ Pump ❑ Pump ❑ Pump <br /> ❑Other ❑ Other ❑Other ❑ Other <br /> Spill Containment Test Results LJ Pass LJ Pass ❑ Pass LJ Pass <br /> ❑ Fail ❑ Fail ❑ Fail ❑ Fail <br /> 7. COMMENTS <br /> Check this box if any spill containment has less than 5 gallons capacity and requires <br /> replacement. <br /> Describe all answers marked "Other." `"No." or ""Fail" and each proposed remedy in Section T. <br /> Page 2 of 2 <br />